Sandtray therapy is a valuable expressive medium for working with children, adolescents, and adults. For some people emotional issues are not easily accessed or expressed verbally, but many find they can express themselves more readily through this creative modality. For children, who often do not yet have the words to explain their emotions, sandtray work gives them another way to create and tell their stories. Once an inner experience has been made tangible in the form of a sandtray picture or "world," the opportunity is created to work with that image, to experience it, share it, revise it, and learn from it. Often, previous unhealthy or unsuccessful ways of approaching difficulties can be discovered and new, healthier solutions generated.

Using a blue-bottomed sand tray and a vast array of miniature figures and natural materials, the client places items of their choice in the tray, which may represent their struggles and challenges. A sandtray session may be directive, with the intent to focus on a particular issue or task, or may be client-centered and spontaneous. In sandtray work, the job of the therapist is to witness the scene as it unfolds, and hold the space for the client to create and explore what they need to. The therapist does not interpret the sandtray picture, but rather allows the creator to tell their own story, making their own interpretations, which may change for them with time. The therapist then facilitates the expression of this self disclosure and exploration. The meaning of the play emerges as the client experiences it and shares it with the therapist.

The creating of sandtray worlds often presents a playful, non-threatening medium to help facilitate change, by allowing clients a glimpse into what troubles them, many times from a perspective not previously accessed or realized.

"Miniatures are the words, symbols, and metaphor of the client's nonverbal communication. It is through the use of the miniatures that clients are able to express feelings, thoughts, beliefs, and desires that may be too overwhelming for words. Or, more typically, for the client using sandtray, providing an expression for that which is still beyond words."
   — Homeyer and Sweeney (1998), Sandtray: A Practical Manual